Provider Demographics
NPI:1619947009
Name:MULLIGAN, BARRY FRANCIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:FRANCIS
Last Name:MULLIGAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 INDIAN HEAD RD
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-3702
Mailing Address - Country:US
Mailing Address - Phone:631-292-2001
Mailing Address - Fax:631-292-2003
Practice Address - Street 1:25 INDIAN HEAD RD
Practice Address - Street 2:
Practice Address - City:KINGS PARK
Practice Address - State:NY
Practice Address - Zip Code:11754-3702
Practice Address - Country:US
Practice Address - Phone:631-292-2001
Practice Address - Fax:631-292-2003
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041918122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist